Nosebleeds are an urgent problem for otolaryngologists, general practitioners, because specialists often encounter it in their work. With this pathology, people of almost all ages seek help. Nose bleeds for a variety of reasons. They are injuries, diseases of the nasal mucosa, general somatic diseases.
Nosebleed statistics
This pathology is most common in children under the age of 10 years. There is blood from the nose of the child both at night and during the day. This symptom also affects people over 50 years of age. Individuals from other age groups are less likely to experience the problem. However, there is another traceable pattern. Men between the ages of 20 and 49 experience more nosebleeds than women in the same age group. Pathology is also characterized by seasonality. Most often, nosebleeds are noted in the autumn-winter period.
So many people are familiar with pathology. About 60% of the inhabitantsof our planet (according to the medical literature) have experienced nosebleeds at least once in their lives. In most cases, it is possible to stop the bleeding without going to the hospital. From 14.7% to 20.5% of people need the help of doctors.
In extremely rare cases, nosebleeds are fatal. For example, in 1999, 4 people died from this pathology in the United States. The most famous death in the history of mankind from a nosebleed is associated with the name of Attila. This man was the ruler of the Huns from 434 to 453
Classification of pathology
Experts have created a huge number of classifications of nosebleeds. Consider, for example, one of them, built according to the pathomorphological principle. According to this classification, bleeding is caused by:
- disturbances in the coagulation properties of blood (for example, in hemophilia, a rare hereditary disease characterized by a violation of blood clotting);
- violation of the vascular system in the nasal cavity (due to trauma, tumors, dystrophic changes in the mucous membrane, curvature of the nasal septum);
- simultaneous action of changes in the vascular system of the nasal cavity and coagulation properties of blood (mucosal degeneration in atherosclerosis or hypertension, etc.).
It is also customary to classify nosebleeds according to the location of their source. They are anterior and posterior (the source is above the middle turbinate or below it), as well as located outsidenasal cavity (from intracranial vessels, paranasal sinuses).
Causes of nosebleeds
Everyone should know what to do if there is a nosebleed. But it is still important to have an idea about the causes of the pathology. There are quite a few of them. They are divided into local and systemic. Local reasons include:
- injuries (finger, from foreign bodies, after surgical interventions);
- upper respiratory infections;
- allergic processes;
- nasal polyps;
- tumors;
- inhalation of irritants;
- negative effect of low air humidity on mucous membranes, etc.
The list of possible systemic causes is long. It includes arterial hypertension, vascular pathology, various coagulation disorders, systemic infections, etc.
Reasons related to certain age characteristics
In the elderly age group, women are most prone to bleeding. With the onset of menopause, changes occur in the body. The mucous membrane of the nose dries up and shrinks. Because of this, the pathology under consideration arises. In young people, nosebleeds develop against the background of physical overstrain, prolonged exposure to the sun.
Adult men, adolescents often have nosebleeds due to injuries sustained in fights. Traumatic bleeding is special. It is characterized by the complexity of pathogenetic mechanisms, a tendency torelapses. Such bleeding is difficult to diagnose, treat and predict.
Pathology in children
Nosebleeds in children deserve special attention. Every mother worries about her baby. When a child begins to bleed from the nose at night or during the day, any woman begins to worry, look for the causes of this pathology, seeks to give the child something to drink in order to prevent the recurrence of such cases in the future. Most of the time there is no cause for concern. Under the age of 10, nosebleeds are a manifestation of the individual characteristics of the mucous membranes of the nose.
It is important to note that the most common cause of nosebleeds in children is finger trauma. Mucus dries up in the nose, crusts form. Their child takes out with his fingers and at the same time injures the mucous membrane. The consequence of this is bleeding.
This frightening and unpleasant symptom should only be a cause for concern when bleeding is too frequent, profuse and long to stop. This may indicate a bleeding disorder. A standard clinical blood test with platelet count and clotting time is required to confirm this.
Clinical picture
The condition of a person with nosebleeds can be different. With insignificant blood loss (from a few drops to several tens of milliliters), there are no special changes, no pathological symptoms are observed. Fainting or hysteria is possible, but, as a rule, only children and people withunstable psyche who do not know what to do if the nose bleeds.
With significant blood loss, certain symptoms appear - weakness, noise and ringing in the ears, flashing black dots before the eyes, palpitations, thirst, dizziness, pallor of the skin and mucous membranes. With blood loss from 15% to 20% of the volume of circulating blood, pressure decreases, shortness of breath, tachycardia appear. The skin acquires a bluish tint, i.e., signs of acrocyanosis appear. With even more significant blood loss (more than 20% of the volume of circulating blood), hemorrhagic shock occurs. Arterial pressure drops sharply, pronounced tachycardia is observed. Consciousness becomes sluggish.
How to stop a nosebleed quickly
To quickly stop bleeding, take simple steps. If you have this unpleasant symptom, sit on a chair and lean forward. Don't tilt your head back for several reasons. First, blood can enter the respiratory tract, provoke vomiting. Secondly, tilting the head back will not help stop the nosebleed quickly. As you know, this position of the body worsens the venous outflow of blood from the head and neck. As a result, the pressure in the blood vessels of the head increases. This causes increased bleeding. Also don't blow your nose. Such an action can only increase the bleeding.
If your nose bleeds for no reason and the bleeding is minor, take a few deep and long breaths through your nose. Exhale through your mouth. Streams of inhaled air will provoke a reflex spasminjured vessels. As a result, the bleeding will decrease or stop. In case of significant bleeding, apply an ice pack or an ordinary handkerchief moistened with cold water to the nose.
Immediate contact with a specialist
Nosebleeds may require medical attention. Always see a specialist if you have the following indications:
- bleeding resumes or does not stop within 20 minutes after the first action taken;
- bleeding is very significant (blood flows from the nose in a jet, the volume of blood loss is more than 200–300 ml);
- general feeling worse;
- has severe comorbidities;
- As prescribed by a doctor, anticoagulants and antiplatelet agents are taken (drugs that inhibit the activity of the blood coagulation system and prevent thrombosis).
At the hospital, the doctor will diagnose. It includes a thorough history taking to determine the cause of bleeding, measurement of blood pressure and heart rate, examination of ENT organs. The specialist at this stage is looking for answers to important questions - why nosebleeds often bother the patient, whether this is the result of ordinary overwork or some serious illness. An important task is to find the source of bleeding. It may be in the nasal cavity. Often the nose serves as an excretory route for blood. Its source in some cases is in the underlying respiratory and digestive tracts.
Methods of treatment used by doctors
How to stop a nosebleed in an adult? In the hospital, this issue is resolved by carrying out nasal tamponade. The efficiency of this method is somewhere around 80-90%. Plugging is performed using gauze turunda, which is about 60 cm long. It is placed in loops on the bottom of the nasal cavity. When using gauze turunda, blood vessels are tightly pressed against the walls of the nasal cavity. This speeds up the stop of bleeding, the formation of a blood clot. The disadvantages of the method are pain when inserting a tampon, cessation of breathing through the nose.
There are also tampon-free methods to stop nosebleeds:
- Chemical coagulation. The source of bleeding is treated with chemicals (10% carboxylic acid, trichloroacetic acid).
- Cryocoagulation. When choosing this method of stopping nosebleeds, doctors choose 1 of 3 methods - either spray cryotherapy, or cryotherapy around the bleeding area, or freezing the bleeding area.
Drug therapy
With nosebleeds of any etiology, one of the main stages of assistance is drug therapy. Standard remedies for stopping nosebleeds:
- "Dicinon". This drug is used in the form of tablets and solution. The fastest effect is achieved with intravenous administration. This kind of applicationthe drug is chosen, as a rule, for traumatic bleeding.
- "Vikasol". This medicine is also available in the form of a solution and tablets. It is prescribed by doctors with other means to enhance the hemostatic effect. At the "Vikasol", according to experts, the effect is rather weak. The drug begins to act somewhere 12 hours after the first injection.
- Calcium chloride. This tool is used to enhance the main hemostatics. Calcium chloride is prescribed at the beginning of therapy for faster formation of a primary thrombus. In case of traumatic brain injury, the drug is contraindicated.
Surgical treatments
In some cases, to stop the bleeding from the nose in an adult, no matter how scary it sounds, it is possible only by surgical methods. They are necessary for those people who have a recurrent pathology. In such cases, surgical methods are more effective than conservative methods to control bleeding.
Surgery may involve ligation of blood vessels. The indications for such a procedure are the absence of the effect of the posterior nasal tamponade within 48 hours and the decrease in hematological parameters (erythrocytes, hemoglobin, hematocrit, color index).
In conclusion, it is worth noting that there is no need to worry about he alth if bleeding occurs very rarely. This symptom is not always associated with any disease. Very often the cause of bleeding becomes dryindoor air at work, in housing. Abundant, prolonged and frequent leakage (both in women and men) of blood from the nose is a sign of something bad, a signal from the body about serious disorders. In such cases, you need to be examined to find out the exact cause of the pathology and prescribe the right treatment.
